Long-term outcomes in pediatric brain AVMs: beyond radiological cure
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Le résumé fourni par la source
Background Brain AVMs are typically considered cured after angiographic confirmation of nidus obliteration. However, in pediatric patients, recurrence can occur many years later, underscoring the need for long-term clinical surveillance. Event-free survival (EFS) represents a complementary, exploratory metric of therapeutic success that captures time-dependent morbidity. Methods We retrospectively analyzed 46 pediatric patients with brain arteriovenous malformations (bAVMs) treated between 2013 and 2025. Clinical data, bAVM characteristics, treatment strategies, and outcomes were systematically collected. EFS was defined as the absence of clinically significant neurological complications throughout follow-up, whether early or late, and attributable to bAVM natural history or treatment-related effects. Kaplan–Meier survival analysis was performed to assess EFS by radiological cure status. Long-term functional outcomes were evaluated using the modified Rankin Scale (mRS). Results Median age was 9.8 years; 78.3 % presented with hemorrhage. Radiological cure was achieved in 77.5 % of patients completing treatment. At final follow-up (median 56.5 months; 64 months in the EFS subset), 87 % had a favorable outcome (mRS ≤2). Clinical events occurred both early (≤30 days) and late (>30 days), with late events predominating. Over 30 % of patients with confirmed radiological cure experienced events. Long-term events were not associated with hemorrhagic onset, nor with urgent surgical treatment, suggesting they are not merely acute-phase complications. Two angiographic recurrences occurred after more than 9 years. Conclusion Event-free survival (EFS) is a complementary metric that reflects long-term morbidity from both natural history and treatments, highlighting the persistence of events beyond radiological cure and supporting extended follow-up in pediatric AVMs.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Long-term outcomes in pediatric brain AVMs: beyond radiological cure
- Date Crossref
- 01/01/2025
- Éditeur
- Elsevier BV
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Policlinico Umberto I pays non établi dans la noticeÉtablissement de santé
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Bambino Gesù Children's Hospital pays non établi dans la noticeÉtablissement de santé
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Sapienza University of Rome Department of Neurosurgery pays non établi dans la noticeUniversité ou école supérieure
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University of Naples Federico II Department of Electrical Engineering and Information Technology (DIETI) pays non établi dans la noticeUniversité ou école supérieure
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Hospital Del Mar Department of Neurosurgery pays non établi dans la noticeÉtablissement de santé
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Bambino Gesu' Children Hospital Neurosurgery Unit pays non établi dans la noticeÉtablissement de santé
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Department of Functional and Interventional Neuroradiology pays non établi dans la noticeInstitution
Policlinico Umberto I, Bambino Gesù Children's Hospital et Department of Neurosurgery — Sapienza University of Rome, avec 4 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.